Individual
MS. JENNIFER EDGE
Active
Individual
MS. JENNIFER EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
CSW007295
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
CSW007295
GA
172V00000X
Community Health Worker
—
—
Other
Enumeration date
11/02/2018
Last updated
03/28/2024
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